Project Crossfoot
02 · Explorer

Prior authorization denial rates, plan by plan

Every plan that published a CY2025 filing. Search for an insurer or a plan by name, narrow by state or market, and the charts and the weighted rate below recompute as you go.

Reset
8 of 658
filings in view
141K
standard requests
18.4%
volume-weighted denial rate
1
with validation findings

The weighted rate is computed over filings in view that published both a request total and a denial count; the request figure beside it counts every filing in view.

Distribution of denial rates
filings per 10-point band · click a bar for its filings
2
3
2
1
0–10%
10–20%
20–30%
30–40%
40–50%
50–65%
Denial rate vs. request volume
log volume, 1K → 500K · orange marks carry findings · click a point for the filing
1K10K100K500K
Request volume by market, current filter
Medicaid Managed Care 118K 3 filings
Marketplace QHP 19K 2 filings
CHIP Managed Care 3K 2 filings
Medicare Advantage 671 1 filings
Where the denial rate is highest
volume-weighted per state · floor 10K requests · top 10 · click a state for its filings
DE 18.4% 141K · 8 filings
Organizations by denials in view
standard denials summed over the slice · weighted rate beside each · top 10
AmeriHealth Caritas Family of Companies 21K 29.1%
Centene 3K 15.1%
Highmark 2K 3.9%
Rate spread by market
the box is the middle half of the market's rates, the whisker runs 10th–90th percentile, the median is marked · orange dots are the filings past the 90th · click a box for the market, a dot for the filing
0%10%20%30%40%50%60%Medicaid Managed Care3 filingsAmeriHealth Caritas Family of Companies · AmeriHealth Caritas Delaware (Medicaid) — 28.3%Centene · Delaware First Health Medicaid — 12.8%Highmark · Highmark Medicaid - Delaware — 1.5%CHIP Managed Care2 filingsAmeriHealth Caritas Family of Companies · AmeriHealth Caritas Delaware CHIP — 48.4%Centene · Delaware First Health CHIP — 12.1%Marketplace QHP2 filingsCentene · Ambetter Health of Delaware — 27.7%Highmark · Highmark QHP (federal Marketplace) - Delaware — 8.3%Medicare Advantage1 filingHighmark · Highmark Medicare Advantage contract H7710 — 12.4%
How concentrated the denials are
plans ranked by denials, cumulative share · the dashed diagonal is every plan equal
25%50%75%100%0%25%50%75%100%top 10% of plans → 76.7% of denials10% of plans → 77% of denialsplans, ranked by denials →share of all denials ↑
What the slice actually discloses
how much of the current view can be checked — a rate without counts is a claim, not a number
■ 8 publish counts ▨ 0 publish no counts — a rate nobody can check ● 1 carry validation findings

Filings

This view as JSON
Sort
Denial rate Volume Organization Findings
Organization
Plan
Market
St
Std reqs
Denial rate
Findings
AmeriHealth Caritas Family of Companies AmeriHealth Caritas Delaware CHIP CHIP Managed Care DE 3K 48.4% 1 AmeriHealth Caritas Family of Companies AmeriHealth Caritas Delaware (Medicaid) Medicaid Managed Care DE 71K 28.3% — Centene Ambetter Health of Delaware Marketplace QHP DE 3K 27.7% — Centene Delaware First Health Medicaid Medicaid Managed Care DE 15K 12.8% — Highmark Highmark Medicare Advantage contract H7710 Medicare Advantage DE 671 12.4% — Centene Delaware First Health CHIP CHIP Managed Care DE 618 12.1% — Highmark Highmark QHP (federal Marketplace) - Delaware Marketplace QHP DE 16K 8.3% — Highmark Highmark Medicaid - Delaware Medicaid Managed Care DE 32K 1.5% —